Pelvic health for men and women is a medical area of increasing importance, at least in part due to an aging population. Examples of common pelvic ailments include incontinence (e.g., fecal and urinary), pelvic tissue prolapse (e.g., female vaginal prolapse), and conditions that affect the pelvic floor. Pelvic disorders such as these can result from weakness or damage to normal pelvic support systems. Common etiologies include childbearing, removal of the uterus, connective tissue defects, prolonged heavy physical labor and postmenopausal atrophy.
In more particularity, pelvic floor disorders include cystocele, rectocele, and prolapse such as anal, uterine, and vaginal vault prolapse. Vaginal vault prolapse is a condition that occurs when the upper portion of the vagina loses its normal shape and moves downwardly into the vaginal canal. In its severest forms, vaginal vault prolapse can result in the distension of the vaginal apex outside of the vagina. Vaginal vault prolapse may occur alone, such as can be caused by weakness of the pelvic and vaginal tissues and muscles, or can be associated with a rectocele, cystocele, or enterocele. A rectocele is caused by a weakening or stretching of tissues and muscles that hold the rectum in place, which can result in the rectum moving from its usual location to a position where the rectum presses against the back wall of the vagina. A cystocele is a hernia of the bladder, usually into the vagina and introitus. An enterocele is a vaginal hernia in which the peritoneal sac containing a portion of the small bowel extends into the rectovaginal space.
It is known to treat vaginal vault prolapse by suturing the vaginal vault (e.g., by stitches) to the supraspinous ligament, or by attaching the vaginal vault through mesh or fascia to the sacrum or another posterior location. Generally, these treatments include, abdominal sacralcolpopexy (SCP), which may be performed laparoscopically, and transvaginal sacralcolpopexy (TSCP), wherein these procedures are performed using a variety of different instruments, implants, and surgical methods. Sacral colpopexy involves extending an implant (e.g., a “Y-sling” or “Y-mesh”) between tissue to be supported (e.g., tissue of a vaginal vault) and supportive tissue (e.g., tissue at a posterior pelvic region such as at a region of sacral anatomy). The implant is secured to the vaginal tissue at one end and to supportive tissue at another end, to provide therapeutic support for the supported tissue. Implants for these procedures are known, as described and illustrated at Applicant's co-pending application having U.S. Publication No. 2012/0022318, filed Oct. 4, 2011, by Thierfelder et al., entitled IMPLANTABLE ARTICLE AND METHOD, the entirety of which is incorporated herein by reference. These and similar procedures can involve relatively lengthy surgical procedure times and recovery periods.
There is ongoing need in obtaining improved, e.g., minimally invasive, safe, effective and efficient, methods for treating pelvic conditions including incontinence, vaginal prolapse (e.g., vaginal vault prolapse), and other pelvic organ prolapse conditions.